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目的分析宁夏地区成人化脓性脑膜炎(purulent meningitis in adult,APM)脑脊液细菌构成,并探讨其细菌培养阳性患者的特点。方法收集我院近13年来收治的201例APM患者的临床资料,回顾性分析144例行细菌培养的脑脊液细菌构成并比较致病菌检出阳性病例(CP组)与阴性病例(CN组)的临床及实验室特点。结果 APM的细菌检出阳性率为36.81%,致病菌以革兰阳性球菌常见(64.15%),其中以凝固酶阴性葡萄球菌最多,金黄色葡萄球菌次之;CP组年龄、男性病例数、以意识障碍及癫痫发作表现者显著高于CN组(P<0.05),且其血中性粒细胞比例、脑脊液白细胞计数及脑脊液蛋白含量均较CN组高(P<0.05);在发病10 d内就诊的患者,CP组脑脊液压力、脑脊液白细胞计数、脑脊液中性粒细胞比例均较CN组高,脑脊液淋巴细胞比例较CN组低(P<0.05)。结论成人APM的致病菌以革兰阳性球菌多见,其细菌培养阳性患者的临床特点与培养阴性者有差异,可早期预测细菌培养结果。
Objective To analyze the bacterial composition of cerebrospinal fluid (CSF) in adult purulent meningitis in adult (APM) patients in Ningxia and to explore the characteristics of the bacterial culture positive patients. Methods The clinical data of 201 patients with APM admitted to our hospital for 13 years were collected. The bacterial composition of CSF in 144 patients was retrospectively analyzed. The positive cases (CP group) and negative cases (CN group) Clinical and laboratory characteristics. Results The positive rate of bacteria in APM was 36.81%. The most common pathogens were gram-positive cocci (64.15%), the most was coagulase-negative staphylococci, the second was Staphylococcus aureus. The age of CP group, the number of male cases, The patients with disturbance of consciousness and epilepsy were significantly higher than CN group (P <0.05), and the ratio of neutrophil, cerebrospinal fluid leukocyte and cerebrospinal fluid protein content were significantly higher than CN group (P <0.05) The patients in the CP group had higher cerebrospinal fluid pressure, cerebrospinal fluid white blood cell count and cerebrospinal fluid neutrophil ratio than those in CN group. The proportion of cerebrospinal fluid lymphocytes in CN group was lower than that in CN group (P <0.05). Conclusion The pathogens of adult APM are more common in Gram-positive cocci. The clinical features and culture negatives of patients with positive bacterial culture are different, and the results of bacterial culture can be predicted early.